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gUIH <br /> Body Art Inspection Report <br /> Date: 10/24/22 <br /> San Joaquin County Environmental Health Department Program <br /> n 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> „J Record: PRO)000= <br /> / (209)468-3420 <br /> www.siogv.orp/ehd Program <br /> Element: 4121 <br /> =aciity Narre Address City Zip Code <br /> _ost Dreams Tattoo and Piercing 5920 Pacific Ave Stockton 95207 <br /> Vame of Pe-mit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Oichael Carer Routine <br /> The above facility is inspected for compliance with Division 104,Part 15,Chapter 7 of California Health and Safety Code(HSC). <br /> V=Violation C=Corrected On Site <br /> v CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION Cont. C <br /> Parts replaced between clients-grommets,elastic bands, <br /> ] 1. .autoclave:approved and effective-passed integrator test El ❑ 22. etc. ❑ <br /> ] <br /> tems washed,disinfected,packaged, labeled,and 2' sterilized ❑ PREVENTING CROSS-CONTAMINATION <br /> ] 3. .autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ] 4. integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ El] 5. a ro riatel El Chemical used: <br /> nvoices and log kept for disposable,pre-sterilized <br /> ] 6. ui ment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ <br /> Sharps containers labeled, used,and disposed of <br /> 7 ❑ Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' El ElEl26. Barriers used <br /> sterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks, pigments, needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, <br /> El 11. ❑ ❑ 30. Cross-contamination avoided during all phases of procedure Elhot water <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs, armrests,etc. in 14. used ❑ ❑ 33' good repair ❑ <br /> CUSTJMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. ❑ El ❑35. Operation and employee training records present <br /> procedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> ❑ <br /> Client records approved and available-Consent form and 18. El ElEl37. Permits obtained and available <br /> uestionraire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received by(Print): Michael Carter Received by(Signature): Phone:209-696-5757 <br /> Specialist Print): P nne Chao Specialist(Signature): Phone:209-468-3854 <br /> Re nspection on/about: A reinspection fee of$156 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />